Head-to-head comparison of two automated insulin delivery systems in children with type 1 diabetes during a two-week summer camp: an exploratory prospective study.

INTRODUCTION Automated insulin delivery (AID) systems offer superior glycaemic control compared to non-AID in children with type 1 diabetes, yet their performance during real-life challenges, such as summer camps with physical activity, remains underexplored. This study evaluated AID efficacy based on time range (70-180 mg/dL), comparing AID systems against sensor-augmented pump therapy (SAP) during a summer camp in children with type 1 diabetes. METHODS Data were collected from a 14-day diabetes camp (July 2024) involving 26 children (mean+SD age 10±1.3 years, using Medtronic MiniMed 780G (n=13), CamAPS FX (n=7) or SAP (n=6). CGM-derived metrics for the two AID systems and SAP were compared by means of t-tests or Mann-Whitney U-tests (p ≤ 0.05). RESULTS Both AID systems showed a similar time in range over the camp (primary endpoint, 75.5±7.5% for MiniMed 780G vs. 71.1±11.16% for CamAPS FX; p=0.30). No significant differences were found for other glycemic metrics or insulin dosage. Overnight, MiniMed 780G had less time below 54 mg/dL (0.0% (IQR: 0.0; 0.0%)) than CamAPS FX (0.4% (IQR: 0.0; 0.7%); p=0.024). SAP had significantly lower time in range than both AID systems (75.0% (IQR: 70.0; 81.0%) vs. 56.0% (IQR: 55.0; 66.0%); p=0.006). A positive correlation was found between coefficient of variation and the total number of steps (r=0.39; p=0.0459). CONCLUSIONS Despite the camp's challenges, both AID systems were safe and effective, meeting recommended CGM-derived treatment targets. Furthermore, AID systems showed superior glycaemic control compared to SAP.